Proxy measures for the assessment of psychotic and affective symptoms in studies using electronic health records.

Schizophrenia affective disorders clinical assessment tool electronic health records psychosis

Journal

BJPsych open
ISSN: 2056-4724
Titre abrégé: BJPsych Open
Pays: England
ID NLM: 101667931

Informations de publication

Date de publication:
05 Jan 2024
Historique:
medline: 5 1 2024
pubmed: 5 1 2024
entrez: 5 1 2024
Statut: epublish

Résumé

There is a lack of standardised psychometric data in electronic health record (EHR)-based research. Proxy measures of symptom severity based on patients' clinical records may be useful surrogates in mental health EHR research. This study aimed to validate proxy tools for the short versions of the Positive and Negative Syndrome Scale (PANSS-6), Young Mania Rating Scale (YMRS-6) and Montgomery-Åsberg Depression Rating Scale (MADRS-6). A cross-sectional, multicentre study was conducted in a sample of 116 patients with first-episode psychosis from 12 public hospitals in Spain. Concordance between PANSS-6, YMRS-6 and MADRS-6 scores and their respective proxies was evaluated based on information from EHR clinical notes, using a variety of statistical procedures, including multivariate tests to adjust for potential confounders. Bootstrapping techniques were used for internal validation, and an independent cohort from the Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne, Switzerland) for external validation. The proxy versions correlated strongly with their respective standardised scales (partial correlations ranged from 0.75 to 0.84) and had good accuracy and discriminatory power in distinguishing between patients in and not in remission (percentage of patients correctly classified ranged from 83.9 to 91.4% and bootstrapped optimism-corrected area under the receiver operating characteristic curve ranged from 0.76 to 0.89), with high interrater reliability (intraclass correlation coefficient of 0.81). The findings remained robust in the external validation data-set. The proxy instruments proposed for assessing psychotic and affective symptoms by reviewing EHR provide a feasible and reliable alternative to traditional structured psychometric procedures, and a promising methodology for real-world practice settings.

Sections du résumé

BACKGROUND BACKGROUND
There is a lack of standardised psychometric data in electronic health record (EHR)-based research. Proxy measures of symptom severity based on patients' clinical records may be useful surrogates in mental health EHR research.
AIMS OBJECTIVE
This study aimed to validate proxy tools for the short versions of the Positive and Negative Syndrome Scale (PANSS-6), Young Mania Rating Scale (YMRS-6) and Montgomery-Åsberg Depression Rating Scale (MADRS-6).
METHOD METHODS
A cross-sectional, multicentre study was conducted in a sample of 116 patients with first-episode psychosis from 12 public hospitals in Spain. Concordance between PANSS-6, YMRS-6 and MADRS-6 scores and their respective proxies was evaluated based on information from EHR clinical notes, using a variety of statistical procedures, including multivariate tests to adjust for potential confounders. Bootstrapping techniques were used for internal validation, and an independent cohort from the Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne, Switzerland) for external validation.
RESULTS RESULTS
The proxy versions correlated strongly with their respective standardised scales (partial correlations ranged from 0.75 to 0.84) and had good accuracy and discriminatory power in distinguishing between patients in and not in remission (percentage of patients correctly classified ranged from 83.9 to 91.4% and bootstrapped optimism-corrected area under the receiver operating characteristic curve ranged from 0.76 to 0.89), with high interrater reliability (intraclass correlation coefficient of 0.81). The findings remained robust in the external validation data-set.
CONCLUSIONS CONCLUSIONS
The proxy instruments proposed for assessing psychotic and affective symptoms by reviewing EHR provide a feasible and reliable alternative to traditional structured psychometric procedures, and a promising methodology for real-world practice settings.

Identifiants

DOI: 10.1192/bjo.2023.623 PMID: 38179604
pubmed: 38179604
doi: 10.1192/bjo.2023.623
pii: S2056472423006233
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e22

Subventions

Organisme : Fundación Alicia Koplowitz
Organisme : Instituto de Salud Carlos III
ID : PI22/00678

Auteurs

Álvaro López-Díaz (Á)

Mental Health Clinical Management Unit, Virgen Macarena University Hospital, Seville, Spain; Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; Department of Psychiatry, School of Medicine, University of Seville, Spain; and First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain.
ORCID: 0000-0002-6478-4807

Fernanda Jazmín Palermo-Zeballos (FJ)

Mental Health Clinical Management Unit, Virgen Macarena University Hospital, Seville, Spain; and First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain.

Luis Gutierrez-Rojas (L)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; Mental Health Clinical Management Unit, San Cecilio University Hospital, Granada, Spain; Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Spain; and Department of Psychiatry, University of Granada, Spain.

Luis Alameda (L)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland; and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.

Francisco Gotor-Sánchez-Luengo (F)

Department of Psychiatry, School of Medicine, University of Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain.

Nathalia Garrido-Torres (N)

Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain.

Johann Métrailler (J)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland.

Livia Alerci (L)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland.

Vincent Bonnarel (V)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland.

Pablo Cano-Domínguez (P)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen de la Victoria University Hospital, Málaga, Spain.

Elma Avanesi-Molina (E)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen de la Victoria University Hospital, Málaga, Spain.

Miguel Soto-Ontoso (M)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Torrecárdenas University Hospital, Almería, Spain.

Rocio Torrecilla-Olavarrieta (R)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jerez University Hospital, Cádiz, Spain.

Leticia Irene Muñoz-Manchado (LI)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jerez University Hospital, Cádiz, Spain.

Pedro Torres-Hernández (P)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jaén University Hospital, Spain.

Fermín González-Higueras (F)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Jaén University Hospital, Spain.

Juan Luis Prados-Ojeda (JL)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Reina Sofía University Hospital, Córdoba, Spain.

Mario Herrera-Cortés (M)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Reina Sofía University Hospital, Córdoba, Spain.

José Miguel Meca-García (JM)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Poniente University Hospital, Almería, Spain.

Rafael Manuel Gordillo-Urbano (RM)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Infanta Margarita Hospital, Córdoba, Spain.

Cristina Sánchez-Robles (C)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Juan Ramón Jiménez Hospital, Huelva, Spain.

Tomás Delgado-Durán (T)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Juan Ramón Jiménez Hospital, Huelva, Spain.

María Felipa Soriano-Peña (MF)

First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, San Agustín University Hospital, Linares, Spain.

Philippe Golay (P)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland.

Philippe Conus (P)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP), Lausanne University Hospital and University of Lausanne, Switzerland.

Benedicto Crespo-Facorro (B)

Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; Department of Psychiatry, School of Medicine, University of Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain.

Miguel Ruiz-Veguilla (M)

Translational Psychiatry Research Group (PsyNal), Seville Biomedical Research Centre (IBiS), Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Seville, Spain; Department of Psychiatry, School of Medicine, University of Seville, Spain; First-Episode Psychosis Research Network of Andalusia (Red PEPSur), Spain; and Mental Health Clinical Management Unit, Virgen del Rocío University Hospital, Seville, Spain.

Classifications MeSH